FORM 1023-EZ for MASON DIXON ELEMENTARY SCHOOL PARENT TEACHER ORGANIZATION

Field Data
EIN 46-3683949
Case Number EO-2016336-000379
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MASON DIXON ELEMENTARY SCHOOL PARENT TEACHER ORGANIZATION
Organization’s Mailing Address 7041 MASON DIXON HWY
City BLACKSVILLE
State WV
ZIP 26521
Accounting period End 6
Primary contact name KATHERN WILLARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHERN WILLARD
PRESIDENT
25 FAWN MEADOW DRIVE
CORE WV 26541

Officer/Director/Trustee Two

SHANNON MERCER
VICE PRESIDENT
1674 RANGE RD
WADESTOWN WV 26590

Officer/Director/Trustee Three

KYLIE SPEARS
TREASURER
276 WADESTOWN RD
WANA WV 26590

Officer/Director/Trustee Four

CHRISTINE SWANIGER
SECRETARY
433 OAKMONT CT
MAIDSVILLE WV 26541

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2002
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B94 - Parent/Teacher Group
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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